Intense debate over booster doses, Israeli researchers reported on Wednesday a third dose of the Pfizer-BioNTech coronavirus vaccine. Can prevent both infectious diseases and serious illnesses in adults over the age of 60 At least 12 days.
The study, published in the New England Journal of Medicine, looks at whether booster doses are needed for healthy adults and whether booster doses should be given in many parts of the world, as planned by the Byden administration. The latest mass shooting of the conflict. It remains unvaccinated.
Some independent scientists have said that cumulative data so far suggests that only older people need boosters, and perhaps not even them.
According to experts, in all studies published so far, vaccination remains strongly protected against serious illness and hospitalization in the majority of people. However, the vaccine does not appear to be very potent against infections in people of all ages, especially those exposed to the highly contagious delta variant.
Israeli data show that boosters can enhance the protection of older people for weeks. This is not surprising and does not show long-term benefits.
Marion Pepper, an immunologist at the University of Washington in Seattle, said: “But are we trying to achieve that three- to four-month period?”
Federal health officials, including Dr. Anthony S. Forch, President Byden’s best medical adviser on pandemics, point to new evidence from Israel and other countries suggesting that immunity from vaccination declines over time. This justified the plan to distribute booster shots.
The idea sent some Americans Scramble ring for booster shots Steps the FDA may take soon on Friday, even before they are officially approved. But even among government scientists, the idea has been skeptical and angry.
Two scientists who lead the FDA’s vaccine division said they would leave the FDA this fall, partly because they were dissatisfied with the government’s request for booster doses before federal researchers examined the evidence. ..
On Monday, an international group of scientists, including FDA personnel leaving, blamed the promotion of boosters.In their review, scientists were featured in Lancet Analyzing dozens of studies He concluded that the world would be better served by using vaccine doses to protect billions of unvamped people around the world.
“Our main goal in this pandemic was, first and foremost, to avoid all preventable deaths,” said Dr. Soumya Swaminathan, World Health Organization Chief Scientist and co-author of the Lancet Review. Stated. “And there are tools to do it so effectively that we need to use it to prevent death around the world.”
Experts protect unvamped individuals both in the United States and elsewhere to prevent the virus from transforming into a more dangerous form than the delta variant, and perhaps a form that completely circumvents the immune response. There is a more urgent need to do.
WHO is calling on world leaders to refrain from boosting at least until the end of the year, with the goal of immunizing 40% of the world’s population. However, some high-income countries have already begun to provide boosters to residents, and others may follow their lead.
British scientists on Tuesday recommended a third dose to adults over the age of 50 and other medically vulnerable people in the country. France, Germany, Denmark and Spain are also considering boosters for the elderly or have already started administration. Israel has granted boost immunization to all persons over the age of 12 and is already considering a fourth dose of its population.
In a new study, the Israeli team collected data on the effectiveness of booster shots based on the health records of more than 1.1 million people over the age of 60. At least 12 days after the booster, the infection rate dropped by a factor of 11 and became a serious illness. Researchers have found that those who receive the booster are nearly one-twentieth of those who receive it only twice.
Researchers acknowledged that their results were preliminary. Micha Mandel, a professor of statistics and data science at the Hebrew University of Jerusalem, said:
The problem is scientifically complex, as protection from infection is a virtually different goal than protection from hospitalization and death.
Antibodies are the body’s front-line defense against infection. Scientists say that the antibodies that the vaccine produces by stimulating the body inevitably decline over time, making it unlikely that the vaccine will be reliably protected from infection over the long term.
However, the cell branches of the immune system are a heavy weapon against hospitalization and death. The so-called immunological memory encoded in this branch can take several days to start, Stay robust A few months after the first immunization.
There is a problem with booster strategy, some scientists say: tools to prevent hospitalization and death are already at hand. If the goal is to prevent infection, the country will get stuck in a never-ending cycle of booster shots.
Dr. Peter Chin Hong, an infectious disease expert at the University of California, San Francisco, said: “I don’t care about symptomatic illnesses — I care about severe illnesses.”
He added that the only vaccinated patient he saw in the hospital was an adult over 70 years of age with immunodeficiency or other health conditions.
Dr. Forch and other health officials referred to Israeli data when citing the need for boosters Shows an increase in severe illness Among vaccinated people of all ages. However, by grouping all age groups together, the rate can be increased statistically.
Israeli numbers By ageDr. Celine Gounder, an infectious disease specialist at the Bellevue Hospital Center and a former adviser to the Biden administration, said that only people over the age of 60 showed a marked decline in efficacy against serious illnesses.
Understand Vaccine and Mask Obligations in the United States
- Vaccine rules.. August 23, Food and Drug Administration Fully approved by Pfizer-BioNTech’s coronavirus vaccine For people over the age of 16, it paves the way for increased obligations in both the public and private sectors.Private companies Increasingly obligatory vaccines For employees.Such a mission Legally permitted And it has been upheld by court complaints.
- Mask rule.. Centers for Disease Control and Prevention in July Recommended All Americans wear masks indoors in public places within the area of the outbreak, regardless of vaccination status. This is the reverse of the guidance provided in May. Find out where CDC guidance applies, And where The state has its own mask policy.. The battle for masks is controversial in some states. Local leaders against state bans..
- University. More than 400 universities require students to be vaccinated with Covid-19. Almost everything is in the states that voted for President Biden..
- school..both California When New York City Introduced vaccine obligations to education staff. According to a survey released in August, many American parents with school-age children I’m against the vaccines that students are required to do, More support for mask man dates for students, teachers and staff who do not have shots.
- Hospitals and medical centers.. Many hospitals and major healthcare systems require employees to be vaccinated with the Covid-19 vaccine. It cites an increase in the number of cases caused by Delta variants and a stubbornly low vaccination rate in their community, even within their workforce.
- New York City..Workers and customers need vaccination proof Indoor dining, gym, performance And other indoor situations. However, enforcement will not begin until September 13. Teachers and other educational workers The city’s vast school system requires at least one vaccination by September 27, without the option of weekly testing. Municipal hospital workers You will also need to be vaccinated or have a weekly test. Employees in New York have similar rules.
- At the federal level. The Pentagon has announced that it will mandate the country’s coronavirus vaccination. 1.3 million active troops “At the latest” by mid-September.President Biden announced: All private federal officials need to do it Get vaccinated against coronavirus Or submit regular tests, social distances, mask requirements and restrictions on most trips.
“It has long been known that vaccines weaken the immune response of older people,” said Dr. Gounder. “It is not controversial to recommend additional vaccines to the elderly.”
There are other differences between the Israeli and American vaccination campaigns, raising the question of whether the new results are applicable to citizens of both countries. For example, more than 90% of Israelis over the age of 50 are immunized, and older people are more likely to be hospitalized with Covid-19.
FDA scientists acknowledged the restriction on Wednesday, saying that US-based studies “may most accurately represent the effectiveness of vaccines in the US population.”
Previous studies in the United States have also suggested that the effectiveness of vaccines against severe illnesses is reduced only in the elderly. Three studies published last week by the CDC found that vaccines are capable of preventing hospitalization. Barely sprout Even after the arrival of the Delta Variant, except for adults over the age of 75.
Continuous analysis of the Pfizer-BioNTech vaccine shows that efficacy against symptomatic infections has decreased from 95% in the first 2 months to 84% in 4-6 months after the second dose. increase.
However, other data from Pfizer, also released Wednesday, showed the effectiveness of the vaccine against severe illness. Stable at 97%..
“We are confident in the protection and safety of double-dose vaccines,” Pfizer said in a statement. “But we continue to believe that booster doses can be used to maintain the highest possible level of protection for the long term.”
According to some scientists, reduced defense against infection is a compelling argument for boosters for older people. “You will always want to be proactive in the group, not reactive,” said Dr. Chin Hong.
Michel Nussenzweig, an immunologist at Rockefeller University, said booster shots were needed (he was 66 years old), but he also supported the use of them by the general public to break the chain of infections.
The immunity of young people has not yet diminished, but additional doses to prevent infection will reduce the spread of the virus to unvamped people around them, he said.
“It will eventually prevent others from going to the hospital, and it will ultimately benefit the way the country goes,” he added.
Other experts questioned that assumption and said there was no data suggesting that reduced communication was important enough to justify boosters.
For young people, authorities must balance the limited benefits of a third dose with the risk of side effects such as thrombosis and heart problems, the researchers said. Repeated stimulation of the body’s defenses can also lead to a phenomenon called “weakened immunity,” Dr. Pepper said.
“There is clearly some risk in trying to continuously increase the immune response,” she said. “When we enter this cycle of boosting every 6 months, this can be a disadvantage to us.”
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